Today I saw a 3 day old baby that had the most disorganized suck I have
ever seen.  In fact it really was not a suck more of just tongue and jaw
movement.  Mom has rather large nipples, and does a great job getting the
baby well onto the breast.  He appears to suck then pull off and on.  We
could hear a few occasional swallows but mostly after mom used breast
compression.    Instead of forward and back movement of his tongue, his
tongue undulated side to side.  Would not or could not cup his tongue on
my finger.  This baby weighed 9 lbs 41/2 oz at birth and weighed 8lb 6oz
today.  Mom said that the baby has acted like he has been hungry since
birth.  He would latch and pull off many times during the feed.  Was cup
fed at the hospital by her request after nurses suggested it might help
settle him down.  Has given him the pacifier frequently after feeds to
give her comfort from him crying.
        In discussing his birth he was induced.  Short labor, fast descent with
a tight nucal cord, and difficult delivery of shoulders.  3 pees 8pm
yesterday with uric crystals, 2 stools dk green transitional.
        We used SNS at breast which resulted in his staying latched with longer
deeper sucks.  I also taught her how to finger feed since she was so
concerned about doing the SNS without help.  He still would not suck
properly on finger.
        Our plan was to offer the breast (NO PACIFIER) q2-3 hours use SNS to
help him stay on or finger feed after breast.  She was to pump after each
feed to ensure adequate supple and used pumped milk in SNS.  We did
discuss cranial sacral manipulation.  Mom will also closely monitor wet
and dirty diapers.
        Any other suggestions or thoughts from those of you who have had
experience with such a strange tongue action?

TIA
Karen Klusmann RN IBCLC
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